Coronavirus (COVID-19) asymptomatic testing programme: evaluation - November 2020 to June 2021

Conclusions and next steps

Finding cases is the ultimate aim of the testing programme: reducing transmission and saving lives. By this measure, Scotland's asymptomatic testing pathways have performed well. Between 23 November 2020 and 25 June 2021, the number of positive cases identified by LFD testing and confirmed by PCR is 7,271. These are cases that may not otherwise have been detected in the absence of symptoms, or were identified earlier than they otherwise would have been via PCR-based testing once symptomatic.

There were also a range of other positives reported across the testing pathways and from the Scottish Government polling. People felt reassured by being able to access testing, including those in the highest risk cohort. There were also positive comments about receiving information and support to test within workplace settings and that any barriers to testing had been overcome. Employers were positive about testing as a means of keeping their staff and clients safe.

Nevertheless, a number of barriers to the maximum impact of the programme have been found. Individuals do not always have enough information and understanding of the benefits of regular asymptomatic testing. There are ongoing concerns about the accuracy and reliability of tests (even if these are not always based on accurate information), test discomfort, and problems navigating the system. The latter can impact on recording results. It is also clear from this evaluation that people do not necessarily report – or understand why they should report – negative or void results. There are a range of reasons for testing and not testing, including those attached to beliefs and values and more practical concerns. Some of these can be targeted to encourage greater uptake of testing or to alleviate barriers, including streamlining the reporting system, providing more information on carrying out tests and test accuracy, and focusing on the benefits of protecting the community.

A range of models for testing exist, and this evaluation finds that a combination of fixed sites and popup and/or mobile options, as well as home testing, have been described by delivery partners as having the most advantages. A range of lessons have been learned about delivery, including the need for local data to enable planning, clear and streamlined communication between delivery partners and other agencies, and information for those testing, tailored to different audiences. Simplifying the testing landscape may also increase uptake.

This evaluation has found reasons why people test, what enables testing, and what barriers to testing might exist. This information will help to support both practical interventions and communications messaging going forward.

As has been noted throughout, the extent and quality of data varies by pathway. Excepting the Scottish Government polling carried out by YouGov, the research that has been conducted to supplement the wider data is not representative of the groups being surveyed and the engagement shown may not reflect wider engagement across the pathway. Nevertheless, available data has been used to produce as robust and complete an evaluation as possible, draw out information on the performance and public health impact of the asymptomatic testing programme in Scotland, and identify areas that may benefit from improvement or changes.